A patient is diagnosed with Paget disease. What should the nurse ...

[mspears3]

A patient is diagnosed with Paget disease. What should the nurse expect to assess in this patient?
 
  Select all that apply.
  1. pain and aching in the spine at night that is aggravated by pressure
  2. flushing of the skin over the spine
  3. previous pathologic fractures to the vertebra
  4. elevated phosphorus levels
  5. scoliosis

Question 2

During an assessment the nurse notes that a patient has contracture deformities of the hand and complains of severe pain. What musculoskeletal disorder should the nurse suspect this patient is experiencing?
 
  1. rheumatoid arthritis
  2. osteomyelitis
  3. osteoporosis
  4. ankylosing spondylitis

[Melissahxx]

Answer to Question 1

Correct Answer: 1, 2, 3
Most patients that are affected by Paget disease are symptom free for years, and the disease may be seen on an incidental x-ray. The pain is described as a mild to moderate deep ache that is aggravated by pressure and weight bearing. It is more noticeable at night or at rest. Because of the increase in blood flow to pagetic bone, flushing and warmth of the overlying skin may be apparent. Pathologic fractures from the loss of bone structure are a complication of Paget disease. Hypercalcemia, not hyperphosphatemia, is found during laboratory analyzing. Lordosis, not scoliosis, is observed in those with Paget disease.

Answer to Question 2

Correct Answer: 1
Typical hand deformities in the patient with rheumatoid arthritis include swan neck deformity and ulnar deviation. Osteomyelitis is an infection of the bone and does not result in contracture deformities. It may cause localized tenderness and other signs of infection such as fever, swelling, erythema and lymph node involvement. Osteoporosis may cause pathologic fractures but does not cause joint deformity. Ankylosing spondylitis is a chronic inflammatory arthritis that primarily affects the axial skeleton and leads to pain and progressive stiffness of the spine.